Every woman experiences pregnancy differently. Some may breeze through it with that wonderful glow while others may experience nausea for the majority of the nine months. A woman’s body undergoes numerous changes during this time and the mouth is no exception. Good oral health care is essential during this time and there should be a conscious increase in preventative care.
Common oral problems during pregnancy:
Erosion of teeth
During pregnancy, the oral cavity is exposed to an increase of gastric acid due to morning sickness, hyperemesis gravidarum or reflux. The increased levels of gastric acid can cause erosion of teeth.
Women are advised to rinse their mouth with a teaspoon of baking soda in a glass of water after vomiting and not brush immediately to avoid brushing the acid into their teeth. Management also includes seeking medical advice on reducing acid exposure through dietary and lifestyle changes or the use of antiemetic’s or antacids.
Caries
Pregnant women are at a higher risk for developing dental caries due to sugary cravings, increased levels of oral acidity and a reduction in oral care. Pregnant patients are encouraged to reduce their risk of decay by brushing twice daily with fluoridated toothpaste, flossing, reducing their sugar intake and maintaining regular visits to the dentist.
Pregnancy oral tumor
Pregnancy oral tumour is a benign vascular lesion caused by a combination of increased progesterone levels, irritants and bacteria. Up to 5% of women experience these lesions during pregnancy and they usually appear red, smooth and lobulated. They are most frequently found on the gums but can also present on the tongue, palate and inner cheek. These tumours are most common during the first trimester and classically recede after delivery. Management usually involves observation unless the tumour bleeds or interferes with oral hygiene or eating.
Mobile teeth
The increased levels of oestrogen and progesterone can cause tooth mobility during pregnancy. This condition is usually temporary in cases with minimum mobility and in the absence of other conditions.
Gingivitis
Gingivitis is inflammation of the gum tissue and is characterized by redness, swelling, tenderness or bleeding of the gums. 60 to 75% of women experience gingivitis during pregnancy. Approximately half the women with pre-existing gingivitis have a significant exacerbation during pregnancy. Gingivitis is aggravated by variations in hormone levels in combination with changes in oral flora and a decreased immune response.
Thorough oral hygiene measures, including tooth brushing and flossing, are recommended to minimise inflammation. Patients with severe gingivitis may require professional cleaning followed by the use of medicated mouth rinses.
Periodontitis
Periodontitis is a more destructive inflammation of the tissues surrounding the teeth. Toxins produced by bacteria, cause a chronic inflammatory response, resulting in tissue breakdown and pockets of infection.
Management of periodontitis during pregnancy is based on early diagnosis and deep root scaling. The American Academy of Periodontology recommends that women who are pregnant or planning to become pregnant undergo periodontal examination and any necessary treatment. Women with pre-existing periodontal disease can reduce the risk of it worsening during pregnancy through proper oral hygiene.
Dental care during pregnancy:
Daily dental care routine:
Maintain a good oral hygiene regime which should include brushing twice daily with fluoridated toothpaste and flossing at least once a day.
Routine screening and prevention:
A common misconception is that all dental treatment including scaling and polishing should be stopped during pregnancy. It is recommended that pregnant patients maintain their 6 monthly dental visits, to ensure optimal oral health as well as to assess and treat any conditions in the early stages. Professionally applied preventative measures such as fluoride treatment can also assist in maintaining good oral health. Most non-emergency conditions can be deferred to the second trimester or after birth. Often your dentist will work with your treating doctor/gynaecologist to ensure that you receive the safest treatment for you and your baby.
Xylitol & chlorhexidine
The topical use of Xylitol pastes and chlorhexidine mouthwashes can reduce the transmission of cavity causing bacteria from mother to child. These products can be used during late pregnancy or in the postpartum period.
Neutralize the acid:
If you suffer from morning sickness, hyperemesis gravidarum or gastric reflux, rinsing with 1 teaspoon of baking soda in a glass of water, may help neutralize the associated acid.
Ease the gagging reflex:
You can help ease gagging during brushing by using a toothbrush with a small head and taking your time while brushing. It may help to close your eyes and concentrate on your breathing or try distractions such as music. If the taste of the toothpaste seems to provoke the reflex, try switching brands.
Avoid the sugary snacks
We know it’s not easy, especially when those cravings start but try choosing healthier options such as fresh fruit. If you do happen to give in, ensure that you rinse with water after a snack.
Maintain a healthy diet
In addition to avoiding the sweet treats, frequent snacking should be avoided as it increases the likelihood of tooth decay. Maintaining a healthy balanced diet will also benefit your baby as their first teeth begin to develop at 3 months into pregnancy. Dairy products and other sources of calcium will provide baby with essential minerals for developing healthy teeth, gums and bones.
One of the first things your baby will see is your smile! So don’t forget to work with your dentist in taking care of those pearly whites while enjoying your pregnancy.
By Dr Saadia Desai
